摘要
目的系统评价现有结直肠癌(CRC)患者手术部位感染(SSI)风险预测模型研究。方法检索PubMed、Embase、Web of Science、Cochrane Library、CNKI、VIP和万方等数据库中关于CRC患者SSI预测模型相关研究,检索时限为建库至2025年4月。由2名研究者独立完成文献筛选和信息提取,并使用PROBAST工具对文献进行偏倚风险评估。结果共纳入25篇文献,SSI发病率为4.35%~29.47%,包括35个CRC术后SSI风险预测模型。各模型的受试者工作特征曲线下面积(AUC)均>0.7;12项研究进行了内部验证,4项进行了内外部验证;预测因子数量最终纳入为2~13个,其中糖尿病、手术时间、手术方式、术前低蛋白血症、身体质量指数(BMI)、年龄是高频预测因子;所有研究均被评价为高偏倚风险,14项研究被评价为低适用性风险。结论现有CRC术后SSI风险预测模型整体预测性能良好,但存在样本量不足、缺乏外部验证等局限性,模型质量有待提高。未来模型开发应严格遵循PROBAST标准,加强前瞻性、大样本、多中心的研究设计,重视并规范外部验证流程、数据科学处理与报告,以提高模型质量及临床适用价值。临床实践中,应重点关注有高频危险因素的患者,针对性地采取干预措施以降低SSI发生风险。
Objective To systematically evaluate the studies on existing risk prediction models for surgical site infection(SSI)in patients with colorectal cancer(CRC).MethodsRelevant studies on SSI prediction models for CRC patients were retrieved from PubMed,Embase,Web of Science,Cochrane Library,China National Knowledge Infrastructure(CNKI),VIP,and Wanfang.The retrieval period was from the establishment dates of the databases to April 2025.Two researchers independently conducted literature screening and information extraction,and evaluated the risk of bias in the literatures using PROBASTtool.Results A total of 25 literatures were included in the analysis,and the incidences of SSI were 4.35%-29.47%,including 35 risk prediction models of SSI following CRC surgery,The areas under the curve(AUCs)of the receiver operating characteristic(ROC)of models were all>0.7.12 studies underwent internal validation and 4 studies underwent internal and external validation.The final number of included predictors was 2-13.Diabetes,duration of operation,operation mode,preoperative hypoproteinemia,body mass index(BMD),and age were high frequency predictors.All studies were evaluated as with risk of high bias,while 14 studies were evaluated as with risk of low applicability,ConclusionThe overall predictive performance of existing prediction models for SSI following CRC surgery is good,however,there are limitations such as insufficient sample size and lack of external validation,and the quality of models needs to be improved.Future model development should strictly follow the PROBASTstandard,strengthen the design of prospective and multicenter study with large sample size,attach importance to and standardize external validation processes,scientific processing,and data reporting,so as to improve model quality and clinical applicability value.In clinical practice,special attention should be paid to patients with high-frequency risk factors,and targeted intervention measures should be taken to reduce the risk of SSI occurrence.
作者
侯素颖
楚鑫
徐小红
罗微
肖玲怡
李自力
HOU Suying;CHU Xin;XU Xiaohong;LUO Wei;XIAO Lingyi;LI Zili(School ofNursing,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Department of Nursing,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China)
出处
《中国感染控制杂志》
北大核心
2025年第12期1818-1828,共11页
Chinese Journal of Infection Control
关键词
结直肠癌
手术部位感染
风险预测
预测模型
系统评价
colorectal cancers
surgical site infection
risk prediction
predictive model
systematic review
